Qianqian Zuo

Lanzhou University Second Hospital
China

Abstract Title: Symptom Clusters in Postoperative Glioma Patients undergoing Concurrent Chemoradiotherapy: A Network Analysis

Biography:

Ms. Qianqian Zuo is currently a Master's degree candidate in Nursing and works as a registered nurse in the Department of Neurosurgery at Lanzhou University Second Hospital, Lanzhou, China. Her research focuses on neuro-oncology nursing, psycho-oncology, symptom management, and quality of life in brain tumor patients.

Research Interest:

Objective: To characterize symptom clusters in glioma patients during postoperative concurrent chemoradiotherapy and to explore interrelationships among symptoms using network analysis, providing evidence to support precise symptom management.

Methods: A cross-sectional study recruited 374 glioma patients from two tertiary hospitals between December 2024 and January 2026. During the second week of postoperative concurrent chemoradiotherapy, the Chinese version of the M.D. Anderson Symptom Inventory-Brain Tumor Module (MDASI-BT) was used to assess symptom occurrence, severity, and interference. Exploratory factor analysis extracted latent symptom structures, and network analysis identified core and bridge symptoms.

Results: Among 22 symptoms, 15 had an incidence ≥20%. Fatigue (80.0%), distress (64.8%), and pain (52.5%) were most prevalent. Work-related activities were the most severely affected interference domain (mean = 3.9). Six symptom clusters were identified: somatic–neuroregulatory (dry mouth, irritability, difficulty concentrating, bowel problems, sleep disturbance, visual impairment), gastrointestinal (nausea, vomiting, appetite loss), cognitive impairment (speech difficulty, impaired comprehension, dyspnea, drowsiness, memory impairment), neurological dysfunction (numbness, weakness), neuropsychiatric (distress, seizures), and pain–fatigue–related (pain, fatigue, appearance change). Network analysis revealed that weakness, distress, sadness, difficulty understanding, and drowsiness were the most central symptoms (strength centrality). Distress, nausea, speech difficulty, numbness, and appearance change emerged as bridge symptoms connecting different symptom clusters. Network accuracy and stability were satisfactory (strength and closeness CS coefficients = 0.90).

Conclusions: Glioma patients experience substantial symptom burden during postoperative concurrent chemoradiotherapy, with six distinct symptom clusters. Central symptoms (weakness, distress, sadness, difficulty understanding, drowsiness) and bridge symptoms (distress, nausea, speech difficulty, numbness, appearance change) should be prioritized in clinical assessment and intervention to achieve more precise symptom management.

Keywords: Glioma; Concurrent chemoradiotherapy; Symptoms; Symptom clusters; Network analysis